Topic Archives: studies have shown

I have developed an ongoing expertise in measurement and methodology as an epidemiologist and then as director of health and science research. I continue to consult in study design, helping people design studies that answer the questions they want to know about.

This expertise also enables me to help people interpret the results of research. When there’s a news report that says “studies have shown” such-and-such, what does that imply for your life? So often, headlines and journalism distort scientific findings. I taught a college course that highlighted these issues, and I continue to help people see beyond the distortions, to be able to understand and interpret scientific studies.

reason and the heart

art by lynn

The heart has its reasons which reason knows nothing of…We know the truth not only by reason, but by the heart.”

Blaise Pascal, the author of these quotes, lived in the middle of the 17th century. He was a mathematician, physicist and Christian philosopher. He made important contributions to the study of fluids, pressure and vacuums. He invented an early mechanical calculator and did major work in probability theory. He also wrote in defense of the scientific method. I find it fascinating that he wrote the statement quoted here. One of his most famous works was in philosophy and theology, Pensées.

I am frequently engaged in academic discussion and writings, and before you know it, subjects are reduced to a series of logical steps and desiccated prose. Topics like joy, goodness, flourishing cannot ultimately be reduced to logical patterns that we can dissect into tiny pieces. They are alive in the lives of people in ways that our words or neuroimaging machines can never fully explain.

My inability to explain what is in my heart does not mean that it is less valid. And when I attend to another person, it is important that I listen analytically to what they say, but it is also so often important that I listen to what is in their heart, beyond their words.

Tools for life

drawing by lynn

drawing by lynn

If you ask yourself how often you have felt deep inner peace or harmony recently, it can call to mind those places, people and situations that promote that sense in you, and that can help you to seek them more.

When I developed the set of 16 questions in the DSES it was originally for the purpose of research and evaluation. More frequent Daily Spiritual Experiences have been shown to be connected to many good things in life in over 200 research studies. But asking the questions has also become a practical tool for people – helping to notice the presence of the transcendent in daily life. When I ask myself if I have found strength in my religion or spirituality, that reminds me that strength can be found there, and reminds me to look for it and draw on it.

I am presenting at a meeting at Harvard School of Public Health in a couple of weeks on how one might research the role of spirituality in large scale studies of health in diverse populations, seeing if and how it might influence gene expression. (Not all 16 questions speak to everyone, but the average of the set addresses the variety of ways we experience the spiritual, the transcendent, in our lives and provides a number score.  They provide a wide variety of questions that address the depth and diversity of our spiritual experiences.)  At Harvard I have been asked to present on my 16 questions, the DSES, as ones that might help in studying the relationship between spirituality and gene expression and health in diverse populations.  One of the reasons the DSES questions are good for research is that they show statistical correlations with good things like relationships and well-being; and it is also then reasonably easy to enhance this aspect of spirituality, giving us a tool for enriching our lives in significant ways.

uniqueness and things in common

irisLynnUnderwood

drawing by lynn

How wonderful that we are not all the same, and that we can still understand each other so often.

It seems normal to assume that the person I am talking to, or trying to understand, is basically like me.  And of course we do have a lot in common.  But this sense of our commonalities gets in the way if I do not step back, again and again, and consider our differences. People have different genetics that even shape things like our physical responses to stress. We each have had different life experiences that influence our responses to events and people and culture. Each person I encounter, from those I am close to, to new people I meet, is different from me, even though we have things in common.

I continue to be amazed at how different we all are. Without attention to our commonalities, medical and social science could not make discoveries, and art could not speak widely. But we all need to fully recognize our individual differences again and again, in order to make progress in understanding—understanding generally about the world, and practical understanding that helps us to relate to others in our ordinary lives. When I developed the 16 questions of the DSES scale of ordinary spiritual experiences I interviewed many many people of various ages, cultures, beliefs, genders, and ethnicities.  And when asked to describe their experiences, each person’s responses were different. The 16 questions group those experiences, and help people see connections with others. That commonality is so important, but recognition that the other person’s experience is valid, and different in some way from my own is essential too.  It is challenging to keep both in mind in our days.

 

neuroethics course syllabus

INTD 381: Introduction Neuroethics
Introduction to Neuroethics
Syllabus
Spring 2008
Professor Lynn Underwood
INTD 381
Time: 9 30-12 30 Mon Tues Thurs Friday
Class Summary:

Ethical issues that relate to our brains and nervous systems are becoming of increasing importance not just for health professionals but for us all. In this class we will engage with ethical issues arising from new discoveries and technologies in Neuroscience and Cognitive Psychology. We will consider implications for individual action and general policies. We will be exposed to the technologies, philosophical assumptions, and conclusions of the research. Topics introduced will include: moral decision-making and the brain; the interpretation of insights provided by neural imaging (e.g. brain scans); legal responsibility and mental illness; pain and suffering; the effects of psychologically potent drugs and technologies and their appropriate use; the role of and appropriate use of enhancement of mental functioning via drugs and other technologies; and ethics of and mechanisms of brain manipulation by marketing, the media, and other non-medical sources. We will also reflect on how the scientific findings and potential interventions, when combined with other sources of knowledge, have implications for what it means to be human. The text for the course will be “Neuroethics: Defining the Issues in Theory, Practice, and Policy” edited by J. Illes. Films and websites will also be used for resources – one film introducing some basics of brain science through narratives of those suffering from brain diseases ( such as depression, Alzheimers, ADHD and schizophrenia), and a fictional film, “Eternal Sunshine of the Spotless Mind”. A class trip or visit from a professional in the field, such as a neurosurgeon or clinical bioethicist is planned. Grades will be based on class participation, short essays and class presentations, a final project (either a researched essay or a creative narrative project), and final essay exam.

Goals of Course:

To engage with the ethical issues that are arising in Neuroscience and Cognitive psychology
To develop opinions about where you stand on various complex issues in this field
To be able to articulate stands regarding policy options
To come to a clearer understanding of what exactly it means to be human by combining the findings of Neuroscience with those in other areas of knowledge
Text:
Neuroethics: Defining the Issues in Theory, Practice, and Policy,J Illes (editor), Oxford University Press, NY, 2006.

Additional readings: Two overview articles from Trends in Cognitive Science will be sent via email as attachments. There may be additional readings on Sakai, in the library, on the web, or sent to you via email. One key article will be: Farah, Martha J., Neuroethics: the practical and the philosophical, Trends in Cognitive Science 9:1, 2005. P 34-40

Also we will read and watch various stories in books and articles of those with Neuro and Cognitive impairments.
Class schedule

Monday Tuesday Thursday Friday

April 17 Film

April 18 Ethics overview
April 21 Brain disease overview

April 22 Film discussion

April 23 text/readings 2

April 24 discussion

April 25 Articles/Chapters as assigned
April 28 Articles/Chapters as assigned

April 29 Alzheimer’s Chapter 7

April 30 text/readings

May 1 Neurosurgery – Class visit Clinical Ethicist

May 2 Final readings/discussion
May 5Projects

May 6 last dayProjects

May 7 Exam

Weighting of assignments:
40% Class attendance, participation in discussion, quizzes, essays, and brief presentations
30% Final Project
30% Final Essay Exam

Final Project: This will be discussed more fully in class. However, you will take a key issue from class or readings. You will draw from the text and articles, do outside research, take a stand on how it needs to be addressed, and describe impact and relevance for action. You may also draw on philosophy, religious studies, literature, visual art, and film to more clearly make your points. This can be a didactic or a creative work. Use APA format for project if in didactic format. You will present on your project in class and lead discussion on the topic.

 

 

syllabus – understanding and interpreting human studies

Understanding and Interpreting Human Studies
INTD 381

Textbook:
Gehlbach, Stephen H. Interpreting the Medical Literature, McGraw-Hill, Amherst, Mass 2006.

There will be a Sakai site on Web4Students associated with this course, and you must be able to access it. Articles will be put up on the site for you to read online or download. It will be enable interaction for project selection.

Class times and schedule:
Class meets from 9:30 to 12:30

Course Summary: Studying people using scientific tools can actually help us and those around us to change behavior wisely and adjust our attitudes to better agree with the way the world operates. This course will introduce some of the key principles in the design of human studies primarily through reading and analyzing studies others have done. It is a challenge to study people. People are unfortunately – or fortunately – “messy”! By reading and interpreting studies of humans, we can make better decisions for ourselves and those we care about. To do that well, we need to know the limitations of the conclusions we can reach given the data presented. This course also addresses the ethical reasons to do research, and ethical concerns both in doing research and interpreting it. There will also be an opportunity to practice designing human research.

Goals:
This is an introductory course – we will work towards the following goals:
1) Be able to read a scientific paper on a human study, especially a medical study, and
a. identify key issues in study design
b. identify some fatal flaws
c. identify some of what you can and cannot conclude from the study
2) Through the reading of papers on human studies be able to identify some of the key factors involved in clinical and human research so that you can:
a. Begin to apply the results – personally and professionally
b. Design human research yourself or with others.
3) Identify some of the key ethical issues in doing human studies and presented when reading about the research of others
4) Apply the results of some specific research studies studied in class to your own life in practical ways.

Class attendance and participation is crucial
Missing even a single class is a real problem in this course. You are getting 3 hours credit for this course, so missing one class is like missing a week of class in the normal semester. Assignment materials will be handed out, and presentations and discussions cannot be made up easily. If you do miss a class it is your responsibility to obtain notes from someone in the class. The text is not a substitute for class participation.

Assignments:
a) Assigned reading. Keep notes on assigned reading. Keeping up with assigned reading is very important and it may also be evaluated by pop quiz or individualized class discussion assessment.
b) Specific project assignments. Make sure these are completed in accordance with the instructions, and submitted on time. Late assignments will not get full credit, and are a real problem as class discussion of assignment material happens the day it is due.
c) You are expected to spend substantive time outside class reading assigned materials and working on projects. The more you put into this course, the more you will get out of it.

Project Assignments:
The following are preliminary descriptions of these assignments. These will be presented in more detail, and possibly refined, as the class develops.

1) Project one
a. Summary – What was the central study question? Explain for the non-expert
b. Terms for Project one: Use these terms to examine the study
* Confounding
* Types of study: More important to describe the architecture of it than to name: Cross sectional, Intervention – (Experimental),Retrospective (Case control – or comparative sample),Variations, Prospective (followup or longitudinal)
* Definitions
* Measurement
* Classifications
* Outcomes
* Selection issues – Bias? Sample? Random?
c. What are the implications for action of this study? What limits keep it from being helpful for action? Discuss strengths and limitations.

2) Second project: Design a study
Think of a question you would like to answer about humans – be specific and clear
Design a study to answer that question.
What kind of study will work best: intervention, cross-sectional, retrospective, prospective, combo
What measures will you use… for each of the variables
How reliable are your measures?
Is there any way to make them more reliable?
How do they connect to the construct of interest- so they enable your study to be useful
How will you “control” the study so that you investigate your question, and not something else?
How will you select your sample?
Think about the various issues we have discussed to date in study design and incorporate them into your study plan.
This assignment will be critiqued by your peers in class.
You will also hand in a hard copy.

3) Final project:
I would suggest that you pick this published study early on in the class, and be collecting your info all along on it.
Take a question that you are interested in answering about human beings that might have practical application to your life or those you care about. Pick something specific.
Pick one original study on the topic in a peer-reviewed medical or social science journal.
Describe the study: Type, selection, measurements, likelihood of having false positive or false negative results…see Gehlbach readings and class notes for prompts for various additional points.
Use what you learned from feedback from project one to improve this project write-up. This project should be in more depth, as you will now know more.
Given the results, what would you advise regarding action and why?
Look at various problems in the study that limits what you can conclude?
Class presentation and hard copy to hand in.
Weighting of assignments:
There will be no final exam in this course
30% Project 1
30% Project 2
40% Project 3